Chronic traumatic encephalopathy (CTE), a progressive chronic disease in the brain that is found in people with a history of continual brain trauma, is found often in athletes. CTE has been a well covered and controversial issue at the professional football level but has attracted less media coverage in other contact sports despite frequent cases. CTE is not an issue to take lightly, since it is a damaging brain injury that can take an athlete's independence, personality, and life away.

According to the Concussion Legacy Foundation, at least one player has been diagnosed with CTE at up to 147 colleges in America. Of those 147, at least 26 schools have three documented cases. Researchers from the VA Boston Healthcare System and Boston University School of Medicine also published a study finding 190 out of 202 former football players in college or the NFL had CTE, including 66 players showing evidence of CTE who only played college ball.

There are many fans of the NFL, allowing a wide discussion of CTE to be focused, but CTE is not just an NFL problem. CTE is a problem for players at every level, including other contact sports such as soccer, rugby, and hockey, yet the NFL is the driving force behind new research because of their huge budget, funding new studies and deepening the knowledge of CTE. The damage done to an athlete's brain after multiple hits is alarming and should raise concerns to all medical and sports programs, prompting for change in how brain injuries are handled.

Brian Wieder MD, a neurosurgeon who has been in practice for more than 20 years, has had close experience with head traumas in the sports industry, working for the Denver Broncos as their neurosurgeon from 2000-2006. Dr. Wieder was present every game, evaluated players for physicals, and was involved with the treatment and decision of athletes to return to the field.

Dr. Brian Wieder

"Medical professionals are not 100 percent sure continuous trauma causes CTE, but have identified an abnormal tau protein. This protein develops in the early stages, near the part of the brain traumatized, and spreads as time goes on, which is why it's considered a chronic disease," said Dr. Wieder, as he explained how this neurodegenerative disorder is very similar to Parkinson's and Alzheimer's.

These tau proteins stop the brain from functioning, and have been connected to continuous hits and traumas, developing a relationship between CTE and the development of these proteins. Based on where the protein accumulates, the symptoms of CTE can vary. For example, aggression and impulsiveness is linked to hits to the frontal lobe, and memory loss is linked with hits to the the temporal lobe. Dr. Wieder also highly suspects a factor other than brain trauma is in play, with some people possibly being at a higher risk due to minor anatomic differences, hereditary susceptibility, and possibly to genetics.

Additionally, chronic traumatic encephalopathy causes symptoms such as memory loss, impulsive behavior, bad judgment, aggression, depression, paranoia, emotional instability, substance abuse, and suicidal thoughts or behavior. First discovered in boxers, CTE was first referred to as "punch drunk" connecting to these athlete's continuous head trauma. Unfortunately, CTE cannot be diagnosed until after the person dies and the brain can be inspected, with no treatment or diagnosis. With no cure or treatment available for CTE, athletes need to consider their lives outside of sports, and note that the damage they may encounter on the field will change who they are as a person in a negative way, if not kill them in the process.

The damage done on the field will change a player in a negative way

"In American sports, athletes need to be honest with themselves first, as well as supervising coaches and parents, acknowledging the full extent that a symptomatic injury is paramount in preventing premature return to play and in keeping their health in mind. Athletes needs to be educated at an early age of the serious and long term consequences that come with brain impact injuries, and should be informed on what is known regarding minor traumatic brain injury in order to make decisions about what is right for themselves and their health within their sport," comments Dr. Wieder, who believes more research needs to be carried out before we begin to limit these sports, as we can't add significant rule changes or equipment without proving the benefit of that change.

Factors involved in CTE need to be better understood before change can be initiated, and Dr. Wieder suggests we begin initiating change through teaching and changing the perception of brain injuries through reeducation. CTE is a bigger problem than just the lawsuits in the NFL, but a life threatening issue that can lead to death. The stigma around brain injuries needs to evolve to a more serious tone, especially amongst athletes.